医联体模式下联动基层医疗机构对糖尿病患者综合管理疗效和费用控制的研究  

作　　者：何咏梅[1] 杨雷[1] 涂禹 王卫[1] 郑小宇[1] 王建[1] 

机构地区：[1]彭州市人民医院,四川彭州611930

出　　处：《健康女性》2020年第3期3-4,2,共3页Women＇s Health

摘　　要：目的:评估医联体联动模式下以专科为带动、社区全科积极参与,合作开展糖尿病管理的临床治疗效果、以及治疗相关费用情况。方法:分别选择彭州地区敖平、利安、致和3个社区65岁以下2型糖尿病患者84例、111例、75例,共计270例。对每一位受试对象进行为期6个月的跟踪管理。对其中129例受试对象进行STEP健康指导。比较管理前后及指导前后各临床、生化指标及治疗相关费用的差异。结果:(1)敖平、利安社区糖尿病患者糖化血红蛋白水平管理后较管理前明显降低(P<0.05);利安、致和社区糖尿病患者收缩压管理后较管理前明显降低(P<0.05)。(2)利安社区糖尿病患者总治疗费用管理后较管理前明显降低(P<0.05),敖平、致和社区糖尿病患者总治疗费用管理后较管理前有所降低,但无统计学差异(P>0.05)。(3)129例接受STEP健康指导的糖尿病患者糖化血红蛋白水平、总治疗费用指导后较指导前均明显降低(P<0.05)。结论:医联体联动模式下开展糖尿病综合管理能改善糖尿病患者临床生化指标,减少并发症发生;并能有效降低患者的总治疗费用。Objective:To evaluate the clinical effect of cooperative diabetes management under the mode of medical association.Methods:a total of 84,111 and 75 patients with type 2 diabetes under the age of 65 were selected from Aoping,Lian and Zhihe communities in Pengzhou district,with a total of 270 cases.Each subject was followed up for 6 months.STEP health guidance was given to 129 of the subjects.Compare the differences of clinical,biochemical indexes and treatment-related costs before and after management and guidance.Results:(1)The hBA1C levels of diabetic patients in Aoping and Lian'an communities were significantly lower after management than before management(P<0.05).Systolic blood pressure in patients with diabetes in Lian and Zhihe communities was significantly lower after systolic blood pressure management than before(P<0.05).(2)the total treatment cost of lian community diabetic patients was significantly lower after management than before management(P<0.05),while the total treatment cost of aoping,zhihe community diabetic patients was reduced after management compared with before management,but there was no statistical difference(P>0.05).(3)The hBA1c level and total treatment cost of 129 diabetic patients receiving STEP health guidance were significantly lower after guidance than before guidance(P<0.05).Conclusion:The comprehensive management of diabetes under the mode of medical association can improve the clinical biochemical indexes of diabetes patients.Effectively reduce the total treatment cost of patients.

关 键 词：糖尿病管理 医联体 总治疗费用 

分 类 号：R58[医药卫生—内分泌]